Cardiovascular health profile of cancer survivors: real-world insights from the Polish Norwegian Study (PONS)

Background The European Society of Cardiology guidelines on cardio-oncology care recommend that oncological patients receive cardiovascular prevention counseling to control cardiovascular risk factors and to promote long-term healthy lifestyle. Purpose To assess the attainment of cardiovascular risk factor control among adult cancer survivors in a community setting and to explore potential gender disparities. Methods Cross-sectional, baseline data from PONS study, a population-based cohort of adults ages 45 to 64 years. From the total sample of 12,697 participants, we analyzed data from 442 individuals (3.48%) who reported having been diagnosed with any type of cancer. Trained technicians administered structured questionnaires, performed anthropometrics and collected fasting blood samples. We performed univariate analysis to assess the prevalence of ‘Life’s essential 8’ ideal cardiovascular health factors, and multivariable logistic regression to estimate predictors of goal attainment. Results There were 343 (77.6%) women and 99 men (22.4%) cancer survivors, with a mean age of 57.7 years (SD 4.7) at a median (IQR) 8 (3-11) years post cancer diagnosis. Participants reported having been diagnosed with coronary heart disease (10.6%), stroke (2.0%), heart failure (9.7%), hypertension (44.1%), diabetes (7.5%), and hyperlipidemia (19.2%). Cardiovascular risk factors control was achieved as follows: not smoking currently, 82%, leisure time physical activity at least 150 min/week, 31.5%, consuming 4 ideal dietary components, 0.45%, at least 2 ideal dietary components, 63.8%, sleep duration 7-9 h, 61.5%, BMI < 25 kg/msq, 26%, blood pressure < 120/80 mmHg, 15.8%, blood pressure < 140/90 75.8%, fasting glucose < 100 mg/dl, 69.9%, LDL-C < 70 mg/dL, 5.66%, LDL-C < 190 mg/dL, 96.3%, visited a doctor within the past year, 88.5%. More men (23.2%) than women (16.6%) reported history of cardiovascular disease, while more women (90.9%) than men (79.8%) visited a doctor during the past year (p< 0.01). No cancer survivor achieved all traditional ‘essential eight’ ideal cardiovascular health factors. More women (27.9%) than men (17.7%) achieved at least three out of the 8 essential factors, OR 1.88, 95% CI 1.06-3.3. This association persisted after adjusting for age, prevalent CVD, doctor visits, education, urban/rural residence, and years post cancer diagnosis, OR= 1.92, 95% CI 1.06-3.50. Conclusion In this ‘real world’ community-based sample of cancer survivors, major cardiovascular risk factors remain poorly controlled, with women displaying a minor potential advantage. Our findings support the need for a more intensive risk factors management and lifestyle change counseling.